Caseous necrosis of the mitral annulus: a new feature of drug-induced valvular heart disease? Case series

Tiphaine Leblon; Clemence Riolet; PierreVladimir Ennezat; Sylvestre Marechaux

doi:10.1093/ehjcr/ytab516

Caseous necrosis of the mitral annulus: a new feature of drug-induced valvular heart disease? Case series

Eur Heart J Case Rep. 2021 Dec 16;6(1):ytab516. doi: 10.1093/ehjcr/ytab516. eCollection 2022 Jan.

Authors

Tiphaine Leblon¹, Clemence Riolet¹, PierreVladimir Ennezat², Sylvestre Marechaux¹

Affiliations

¹ Lille Catholic hospitals, Heart Valve Center, Cardiology Department, ETHICS EA 7446, Lille Catholic University, France.
² Henri Monder University Hospital, Cardiology department, Paris, France.

Abstract

Background: Drug-induced valvular heart disease (DI-VHD) is a well-defined condition associated with specific pathology features. However, clinical presentations may broadly vary and thereby make DI-VHD diagnosis more challenging.

Case summary: We report two patients with a history of benfluorex administration, who developed extensive mitral calcific lesions which evolved towards caseous necrosis.

Discussion: Prospective follow-up over several years of these two patients who initially had typical DI-VHD findings provided monitoring evidence of extensive calcifications and subsequent caseous necrosis. These reports suggest a link between calcific heart injury and benfluorex exposure. The diagnosis of DI-VHD may be overlooked at this late stage.

Keywords: Benfluorex; Case report; Caseous necrosis; Mitral annulus.

Publication types

Case Reports